Wisconsin
Provider Communications

Articles Category: State & Federal

Title Publication Category Date

Medicaid News - July 2021

View these Medicaid articles:
- Specialty pharmacy prior authorization retraction notice
- Infusion step therapy retraction notice
- Specialty Rx precertification additional documentation notice effective August 1, 2021
- Prior authorization requirement changes effective September 1, 2021–UM AROW 1327
- February 2021 medical policies and utilization management guidelines update
July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

What Matters Most: Improving the patient experience

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Resources to support your diverse patient panel

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Coding spotlight: Mental disorders in childhood

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

March 2021 medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021 - UM AROW 1837

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Prior authorization requirement changes effective September 1, 2021

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Updates to AIM Specialty Health Musculoskeletal Program clinical appropriateness guidelines

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Wisconsin Medicaid Jul 1, 2021

Medicare News - July 2021

View these Medicare articles:
- Prior authorization requirement changes effective September 1, 2021 – UM Authorization Rule Operations Workgroup (AROW) Item 1845
- Provider notification for UM Authorization Rule Operations Workgroup (AROW) Item 1846
July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Let’s Vaccinate

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Attention facilities: Sending admission, discharge and transfer data to Anthem results in improved care management for patients

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Medical drug benefit clinical criteria updates

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

Prior authorization requirement changes for codes A0426 and A0428 effective October 1, 2021

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

New reimbursement policy: Modifier 90: Reference (outside) laboratory and pass-through billing

July 2021 Anthem Provider News - Wisconsin Medicare Jul 1, 2021

DEXA bone scan criteria for the Federal Employee Program®

June 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jun 1, 2021

Medicaid News - June 2021

View these Medicaid articles:
- Medical drug benefit Clinical Criteria updates
- Updates to the AIM Advanced Imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Provider education program survey: Your Voice Counts

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

MCG Care Guidelines 25th Edition

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Keeping up with routine vaccination during COVID-19

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Aspire Health for members in need of palliative care

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Complex case management program

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Important information about utilization management

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Members’ Rights and Responsibilities Statement

June 2021 Anthem Provider News - Wisconsin Medicaid Jun 1, 2021

Medicare News - June 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for risk adjustment
- Medical drug benefit clinical criteria updates
- Updates to the AIM advanced imaging clinical appropriateness guidelines
June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Medical policies and clinical utilization management guidelines update

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Reminders for Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Reimbursement policy reminder: Inpatient readmissions

June 2021 Anthem Provider News - Wisconsin Medicare Jun 1, 2021

Medicaid news - May 2021

View these Medicaid articles:
- Maximizing efficient, high quality COVID-19 screenings
- Updates to the AIM Specialty Health Musculoskeletal Program Clinical Appropriateness Guidelines
May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Metabolic monitoring and diabetes screening measures for those on antipsychotics medications

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Aspire Health telehealth palliative care program for Medicaid members in need of telephonic palliative care

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Maximizing efficient, high quality COVID-19 screenings

May 2021 Anthem Provider News - Wisconsin Medicare May 1, 2021

Retraction: AIM Rehabilitative program - initial evaluations and site of service reviews

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Reimbursement policy update: Multiple and bilateral surgery - Professional and Facility

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Continuing medical education and continuing education unit opportunities

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Sign up to receive email from Anthem Blue Cross and Blue Shield

May 2021 Anthem Provider News - Wisconsin Medicaid May 1, 2021

Keep up with Medicare news - May 2021

View these Medicare articles:
- Anthem working with Optum to collect medical records for Medicare Risk Adjustment (MRA)
- Helping our senior members
- Updates to the AIM Specialty Health musculoskeletal Program clinical appropriateness guidelines
May 2021 Anthem Provider News - Wisconsin Medicare May 1, 2021

HEDIS 2021 Federal Employee Program® medical record request requirements

April 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Apr 1, 2021

Medicaid News - April 2021

View these Medicaid articles:
- There is something new happening at Anthem Blue Cross and Blue Shield
- Iron infusion medical step therapy notice
- November 2020 medical policies and utilization management guidelines update
- Prior authorization updates for specialty pharmacy drugs effective April 2021
- Prior authorization required for specialty pharmacy drugs effective May 2021
- Clinical criteria updates notification - November 2020
- Clinical criteria updates notification - December 2020
April 2021 Anthem Provider News - Wisconsin Medicaid Apr 1, 2021

Does your practice offer telehealth services? Let us know!

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

In-Office Assessment program

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Oncology dose reduction program beginning July 1, 2021

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Clinical criteria updates notification - November 2020

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Clinical criteria updates notification - December 2020

April 2021 Anthem Provider News - Wisconsin Medicare Apr 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

MCG Care Guidelines 24th edition customization

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Updated AIM Rehabilitative program effective August 1, 2021 - Site of Care reviews

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Coding spotlight: Overview of the 2021 evaluation and management changes

March 2021 Anthem Provider News - Wisconsin Medicaid Mar 1, 2021

Medicare News - March 2021

View these Medicare articles:
- MCG Care Guidelines 24th edition customization
- DME checklist of information needed from providers
March 2021 Anthem Provider News - Wisconsin Medicare Mar 1, 2021

New provider directory indicator for telehealth services

March 2021 Anthem Provider News - Wisconsin Medicare Mar 1, 2021

Medical policies and clinical utilization management guidelines update

March 2021 Anthem Provider News - Wisconsin Medicare Mar 1, 2021

Access to more claim denial information is now self-service

March 2021 Anthem Provider News - Wisconsin Medicare Mar 1, 2021

Medicaid News - February 2021

View these Medicaid articles:
- Delay of AIM Musculoskeletal Program guideline updates for Medicaid
- New specialty pharmacy medical step therapy requirements
- Provider notification for Utilization Management Authorization Rule Operations Workgroup Item 1326
February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

Availity Portal eligibility and benefits provides both additional benefit notes and digital member ID Cards

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

CAHPS® survey

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

HEDIS Measurement Year 2020: Medicaid summary of changes from NCQA

February 2021 Anthem Provider News - Wisconsin Medicaid Feb 1, 2021

PN for UM AROW Item 1330

February 2021 Anthem Provider News - Wisconsin Medicare Feb 1, 2021

Medical drug benefit clinical criteria updates - February 2021

February 2021 Anthem Provider News - Wisconsin Medicare Feb 1, 2021

2021 FEP® benefit information available online

January 2021 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Jan 1, 2021

Medicaid News - January 2021

View these Medicaid articles:
- August 2020 Medical Policies and Utilization Management Guidelines update
- Independent laboratory provider – Place of service 81
- New specialty pharmacy medical step therapy requirements
- Prior authorization requirements for Moderate to Deep Anesthesia for Dental Surgery in the Facility Setting
- Policy Update: Nurse Practitioner and Physician Assistant Services
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
- Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines
January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

FDA approvals and expedited pathways used - new molecular entities (NMEs)

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Disease Management/Population Health program

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Coding spotlight: HEDIS MY 2021

January 2021 Anthem Provider News - Wisconsin Medicaid Jan 1, 2021

Keep up with Medicare news - January 2021

View these Medicare articles:
- Medicare Advantage Group Retiree Quick Reference Guide and FAQ
- Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ
- SNF admission reporting requirements for D-SNP plans
- Policy Update: Nurse Practitioner and Physician Assistant Services – Professional
- Updates to AIM Clinical Appropriateness Guidelines for Radiation Oncology
- Updates to AIM Specialty Health Cardiac Clinical Appropriateness Guidelines
January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

2020 Medicare risk adjustment provider trainings

January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

Updates to AIM clinical appropriateness guidelines for Advanced Imaging

January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

Updates to AIM Specialty Health Cardiac clinical appropriateness guidelines

January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

Medical drug benefit clinical criteria updates

January 2021 Anthem Provider News - Wisconsin Medicare Jan 1, 2021

Medicaid News - December 2020

View these Medicaid article:
- Anti-VEGF Medical Step Therapy Notice
- Important reminder: Coding requirements for reimbursement for early elective deliveries
- Transition to AIM small joint guidelines

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

CAHPS education for providers

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Notifications on the Availity Portal

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Resources to support your pregnant and postpartum patients and their families

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Sign up to receive email from Anthem Blue Cross and Blue Shield

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Wisconsin Medicaid Dec 1, 2020

Transition to AIM small joint guidelines

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

2021 Medicare Advantage individual benefits and formularies

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

Medicare Advantage Group Retiree Member Eligibility, Alpha Prefix FAQ

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

Medical policies and clinical utilization management guidelines update

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

Policy Update: Emergency Department: Leveling of Evaluation and Management Services

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

Digital transactions cut administrative tasks in half

December 2020 Anthem Provider News - Wisconsin Medicare Dec 1, 2020

Medicaid News - November 2020

View these Medicaid article:
- Evaluation and management services correct coding
- New specialty pharmacy medical step therapy requirements
- Provider Chat: A fast, easy way to get your questions answered
- New specialty pharmacy medical step therapy requirements
- Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations
- Electronic visit verification notification
November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Medical drug benefit clinical criteria updates

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Prior authorization requirements for HCPCS code 55899

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Medicare News - November 2020

View these Medicare articles:
- AIM rehabilitation prior authorizations suspended for Group Retiree Solutions members until December 31, 2020
- Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines
- AIM Musculoskeletal program expansion postponed
November 2020 Anthem Provider News - Wisconsin Medicare Nov 1, 2020

Inhaled nitric oxide reviews for diagnosis-related group admissions

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Transition to AIM Rehabilitative Service Clinical Appropriateness Guidelines

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Provider Chat: A fast, easy way to get your questions answered

November 2020 Anthem Provider News - Wisconsin Medicare Nov 1, 2020

Provider transparency update

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

Digital transactions cut administrative tasks in half

November 2020 Anthem Provider News - Wisconsin Medicare Nov 1, 2020

Coding spotlight: Tips and best practices for compliance

November 2020 Anthem Provider News - Wisconsin Medicaid Nov 1, 2020

FDA approvals and expedited pathways used - new molecular entities

November 2020 Anthem Provider News - Wisconsin Medicare Nov 1, 2020

Federal Employee Program® expands specialty pharmacy prior authorization list*

October 2020 Anthem Provider News - Wisconsin Federal Employee Plan (FEP) Oct 1, 2020

Update: Notice of changes to the AIM Musculoskeletal Program prior authorization requirements and setting determinations

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020

Prior authorization requirements for E0482

October 2020 Anthem Provider News - Wisconsin Medicaid Oct 1, 2020
Page 1 of 4 Next Page